SII-N评分模型预测老年食管癌预后的初步探讨

doi:10.3760/cma.j.cn113030-20190822-00340

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摘要目的评价TNM分期联合系统免疫炎症指数(SII)对老年食管癌是否具有更好的预测价值。方法回顾性分析 118例接受放化疗的老年食管癌患者的临床资料,计算SII值。将SII及临床病理特征纳入Cox模型分析,得出预后指数(PI)方程。应用Kaplan-Meier法生存分析,根据PI分组预测患者生存并比较PI和TNM的预测价值。结果单因素分析显示SII、N分期、TNM分期均与总生存率密切相关(均 P<0.01),多因素分析结果显示SII、N分期是影响总生存率的因素。根据Cox分析结果得出PI=0.961×SII分组+0.523×N分期。根据PI及总生存期绘制受试者工作特征(ROC)曲线,得出临界值并分组。低危组1、2、3年总生存率明显高于高危组(HR=0.365,95%CI:0.221~0.604,P<0.001)。SII-N预测总生存ROC曲线下面积优于TNM分期(0.707:0.560,P<0.001)。结论初步证明SII-N预后评分模型优于传统TNM分期,可能对老年食管癌治疗策略选择具有指导意义,值得进一步研究。

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	陈清清
	崔红霞
	田野
	郭信伟
	徐莹莹
	周俊东
	冀胜军

关键词 ：食管肿瘤,老年, 系统免疫炎症指数, 预后

Abstract：Objective To investigate whether TNM staging combined with systemic immune inflammation index (SII) has a high predictive value for the clinical prognosis of elderly patients with esophageal cancer. Methods Clinical data of 118 elderly patients with esophageal cancer who received radiotherapy and chemotherapy were retrospectively analyzed, and the SII was calculated. SII and clinicopathological features were included in the Cox proportional risk model, and the prognostic index (PI) equation was obtained. Kaplan-Meier survival analysis was adopted. According to PI, the survival of patients was predicted and the predictive values of PI and TNM were statistically compared. Results Univariate analysis showed that SII, N staging and TNM staging were closely correlated with the overall survival (all P<0.01). Cox multivariate analysis revealed that SII and N staging were the independent risk factors for overall survival. According to the results of Cox analysis, the equation of PI=0.961 × SII grouping+ 0.523 × N staging was obtained. The receiver operating characteristic (ROC) curve was drawn according to PI and overall survival, and the critical value was obtained and divided into different groups. The 1-, 2-and 3-year survival rates in the low-risk group were significantly higher than those in the high-risk group (HR=0.365, 95%CI:0.221-0.604, P<0.001). The prediction of overall survival by SII-N[area under curve (AUC)=0.707] was significantly better than that by TNM staging (AUC=0.560, P<0.001). Conclusion This study preliminarily proves that the SII-N prognosis score model is better than the traditional TNM staging, which may have guiding significance for the selection of therapeutic strategies for elderly patients with esophageal cancer, and is worthy of further study.

Key words： Esophageal squamous cell carcinoma,elderly Systemic immune-inflammation index Prognosis

收稿日期: 2019-08-22

基金资助:苏州市肿瘤临床医学中心项目(Szzx201506)

通讯作者: 冀胜军,Email:happy168123@aliyun.com

引用本文:

陈清清,崔红霞,田野等. SII-N评分模型预测老年食管癌预后的初步探讨[J]. 中华放射肿瘤学杂志, 2020, 29(8): 649-653.

Chen Qingqing,Cui Hongxia,Tian Ye et al. Preliminary study of SII-N scoring model in predicting the prognosis of elderly patients with esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(8): 649-653.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20190822-00340 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2020/V29/I8/649

[1] Chen WQ, Zheng RS, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016,66(2):115-132. DOI:10.3322/caac.21338.
[2] Vlacich G, Samson PP, Perkins SM, et al. Treatment utilization and outcomes in elderly patients with locally advanced esophageal carcinoma:a review of the National Cancer Database[J]. Cancer Med, 2017, 6(12):2886-2896. DOI:10.1002/cam4.1250.
[3] 谭立君,刘晓,肖泽芬,等.592例食管癌3DRT的预后分析[J]. 中华放射肿瘤学杂志, 2015, 24(1):10-15. DOI:10.3760/cma.j.issn.1004-4221.2015.01.004.
Tan LJ, Liu X, Xiao ZF, et al. Analysis of outcomes and prognostic factors in 592 esophageal cancer patients treated with three-dimensional radiotherapy[J]. Chin J Radiat Oncol,2015, 24(1):10-15. DOI:10.3760/cma.j.issn.1004-4221.2015.01.004.
[4] Zi-Ming G, Rui-Ying W, Peng D, et al. TNM-PNI:a novel prognostic scoring system for patients with gastric cancer and curative D2 resection[J]. Cancer Manag Res, 2018, 10:2925-2933. DOI:10.2147/CMAR. S169206.
[5] Hari DM, Leung AM, Lee JH, et al. AJCC cancer staging manual 7^th edition criteria for colon cancer:do the complex modifications improve prognostic assessment?[J]. J Am Coll Surgeons, 2013, 217(2):181-190. DOI:10.1016/j.jamcollsurg.2013.04.018.
[6] Mantovani A, Allavena P, Sica A, et al.Cancer-related inflammation[J]. Nature, 2008, 454(7203):436-444. DOI:10.1038/nature07205.
[7] Tong YS, Tan J, Song YJ, et al. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage Ⅲ non-small cell lung cancer[J]. J Transl Med, 2017, 15(1):221. DOI:10.1186/s12967-017-1326-1.
[8] Yang RN, Chang Q, Wang WH, et al. Prognostic value of systemic immune-inflammation index in cancer:a meta-analysis[J]. J Cancer, 2018, 9(18):3295-3302. DOI:10.1097/MD.0000000000013788.
[9] Wang K, Diao F, Chen JH, et al. Prognostic value of systemic immune-inflammation index in patients with gastric cancer[J]. Chin J Cancer, 2017, 36(1):75. DOI:10.1186/s40880-017-0243-2.
[10] 中国非手术治疗食管癌临床分期专家小组.非手术治疗食管癌的临床分期标准(草案)[J]. 中华放射肿瘤学杂志, 2010, 19(3):179-180. DOI:10.3760/cma.j.issn.1004-4221.2010.03.001.
Chinese Expert Group on Clinical Staging of Non-Surgical Treatment of Esophageal Cancer. Criteria for clinical staging of non-surgical treatment of esophageal cancer (Draft)[J]. Chin J Radiat Oncol, 2010,19(03):179-180. DOI:10.3760/cma.j.issn.1004-4221.2010.03.001.
[11] Xiang JD, Zhou LN, Wan XP, et al. Preoperative monocyte-to-lymphocyte ratio in peripheral blood predicts stages, metastasis, and histological grades in patients with ovarian cancer[J]. Transl Oncol, 2017, 10(1):33-39. DOI:10.1016/j.tranon.2016.10.006.
[12] 陈恒琦, 赫捷. 术前外周血中性粒细胞与淋巴细胞比值在食管鳞状细胞癌预后评估中的价值[J]. 中华肿瘤杂志, 2014, 36(4):294-297. DOI:10.3760/cma.j.issn.0253-3766.2014.04.011.
Chen HQ, He J. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after radical resection of esophageal squamous cell carcinoma[J]. Chin J Oncol, 2014, 36(04):294-297. DOI:10.3760/cma.j.issn.0253-3766.2014.04.011.
[13] Casadei Gardini A, Foschi FG, Frassineti GL, et al. Immune inflammation indicators and implication for immune modulation strategies in advanced hepatocellular carcinoma patients receiving sorafenib[J]. Oncotarget, 2016, 7(41):67142-67149. DOI:10.18632/oncotarget.11565.
[14] Shi HT, Jiang YQ, Cao HG, et al. Nomogram based on systemic immune-inflammation index to predict overall survival in gastric cancer patients[J]. Dis Markers, 2018, 2018:1787424. DOI:10.1155/2018/1787424.
[15] Geng Y, Shao Y, Zhu D, et al. Systemic immune-inflammation index predicts prognosis of patients with esophageal squamous cell carcinoma:a propensity score-matched analysis[J]. Sci Rep, 2016, 6:39482. DOI:10.1038/srep39482.
[16] Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus[J]. Medicine (Baltimore), 2017, 96:e5886. DOI:10.1097/MD.0000000000005886.
[17] Kolaczkowska E, Kubes P. Neutrophil recruitment and function in health and inflammation[J]. Nat Rev Immunol, 2013,13(3):159-175. DOI:10.1038/nri3399.
[18] Mammadova-Bach E, Mangin P, Lanza F, et al. PLatelets in cancer. from basic research to therapeutic implications[J]. Hamostaseologie, 2015, 35(4):325-336. DOI:10.5482/hamo-14-11-0065.
[19] Mezouar S, Frere C, Darbousset R, et al. Role of platelets in cancer and cancer-associated thrombosis:experimental and clinical evidences[J]. Thromb Res, 2016, 139:65-76. DOI:10.1016/j.thromres.2016.01.006.
[20] Zhang P, Xi M, Zhao L, et al.Is there a benefit in receiving concurrent chemoradiotherapy for elderly patients with inoperable thoracic esophageal squamous cell carcinoma[J/OL].PLoS One, 2014, 9(8):e105270. DOI:10.1371/journal.pone.0105270.
[21] 汪红艳,孔令玲,王凡,等. 老年食管癌放射治疗疗效及预后影响因素分析[J]. 安徽医科大学学报, 2016,51(8):1188-1191.
Wang HY, Kong LL, Wang F, et al. Analysis on the factors influencing the clinical outcomes and prognosis of radiotherapy for elderly patients with esophageal carcinoma[J]. Acta Univ Med Anhui, 2016, 51(8):1188-1191.